Medical facilities should conduct an annual and ongoing hazards vulnerability analysis to determine credible threats, in conjunction with local, regional and State assessments.  After determining what the facility is at risk for, such as industrial hazards, and potential WMD risks, planning and research can be implemented for appropriate PPE.

Standard precautions must be fully and regularly used for the highest, defensive impact against an infectious agent.  The national standards exist. Routine masking of coughing patients and staff is one example of a standard precaution that is often not initiated at point of entry into the medical system. 

Expansion of isolation capacity is critical to a large-scale infectious event.  Some efforts have been made to plan for the grouping and containment of infectious patients, and expansion of isolation capability.

For an infectious biological agent, the current model of screening, recognition and PPE for TB is a best practice example.  The recognition should be expanded to non-specific droplet risks, such as cough and fever.  

The best practices to be used for bioterrorism incidents may vary from region to region; however, compliance with standard precautions should serve as a baseline and the best practice method should include either Level B or Level C protection depending on the health care facilities' assessed threat, environment, location, and operating condition and feasibility.

A best practice for Level C protection currently is hooded powered air purifying respirators, a chemical resistant laminate suit such as Tyvek F or CPF 3 fabric, chemical resistant boots, a set of surgical gloves under a set of chemical resistant gloves.  The hooded PAPR eliminates the fit testing required of a fitted face mask used in the APR and affords a higher level of protection than the APR, with an additional comfort level and ease of use that will enable a sustained operation.